A fatal case of poisoning by fenitrothion without evidence of chemical exposure

We describe a mysterious fatal case of poisoning by fenitrothion of a male adult. No typical external signs of organophosphate poisoning were found; we observed patchy mucosal hemorrhages of the bronchi and slight parenchymal hemorrhages of the lower lobe of the left lung at autopsy. The stomach contained 10 g of a faintly purplish/reddish viscous fluid with no chemical smell. Gas chromatography and gas chromatography-mass spectrometry analyses of blood specimens revealed substantial amounts of fenitrothion. The concentrations in cerebrospinal fluid, vitreous humor, and urine are also presented. We concluded that the victim probably died of delayed respiratory insufficiency caused by acute fenitrothion poisoning.